Elimination of Soil Transmitted Helminths: One village at a time. Humpress Harrington (B.N, M.Ed) Head, Pacific Adventist University Atoifi Campus

Gut worms = Soil transmitted helminths Worms that live in the intestines – Roundworms – Hookworms – Whipworms

Lifecycle of hookworm juvenile Soil Male Female In person Penetrates skin Infective larvae in soil

Integrated control Worm Tablets Use Formal Toilets Footwear / wash hands

Community-wide treatment Worms killed, but return over time

STH research at Atoifi April 2011 – survey of Atoifi and Na’au April 2012 – survey of Abitona and Sifilo December 2013 – resurvey Na’au March 2014 – STH training workshop August 2014 – survey of Kwai and Ngongosila

Methods A cross-sectional survey All residents older than 1 year were invited to participate by: – Providing a single sample of faeces that was examined using a modified Kato-Katz technique – Completing a questionnaire that asked demographic and STH-related behaviour questions.

Atoifi STH team

Results: 4 villages Participation rate was 52.8%, with 402 participants comprising 49.8% males. Overall prevalence of hookworm was 22.6% (91/402) (CI %-27.1%).

Health infrastructure and behaviours Respondents from Atoifi reported washing hands before eating more often More frequently wore footwear outside Atoifi had safer defaecation practices Related to prevalence of hookworm in the four villages

Island villages: Kwai and Ngongosila Participation rate was 70.7% (576/815) STH prevalence 65.8% (379/576) Roundworm most common Hookworm prevalence 20-30% (similar to Abitona, Na’au, Sifilo) Some whipworm

Action arising from the survey Feedback of results Hospital actions (MDA - albendazole) Community actions

Each village is different! Different prevalences of STH Different issues about toilets Physical challenges Social challenges Cultural challenges

One village at a time! Each village needs a different solution Solutions must come from the community Using mapping and qualitative methods to work in a participatory way looking for long term solutions

Where to Next? Assist the communities to develop their own project proposals for funding for safe water supply and appropriate toilets Write manuscripts for publication Establish Atoifi as the research centre for STH in Solomon Islands Seek additional funds to do STH surveys in other provinces Work closely with Water Supply and Sanitation division of the Ministry of Health and NGOs